| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $20.00 | $46.40 | $170.18 | |
Cigna
| Professional | $25.05 | $25.05 | $25.05 | |
Lucent Health
| Facility | $100.00 | $100.00 | $214.45 | |
Lucent Health
| Professional | $214.45 | $214.45 | $214.45 |